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Post a Comment Outpatient regenerative therapy of a chronic diabetic foot ulcer with exposed bone surface
- Authors: Pavlova O.V.1, Kalsin V.A.1, Konoplyannikov M.A.1,2, Kuznetsova S.M.1, Baldin V.L.1, Sukhanova Y.S.3, Smirnov A.V.1, Baklaushev V.P.1,3,4,5, Ivanov Y.V.1
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Affiliations:
- Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies
- First Sechenov Moscow State Medical University (Sechenov University)
- Russian National Research Medical University named after N.I. Pirogov
- Federal Center of Brain Research and Neurotechnologies
- Pulmonology Scientific Research Institute
- Issue: Vol 15, No 2 (2024)
- Pages: 116-126
- Section: Case reports
- URL: https://journals.rcsi.science/clinpractice/article/view/262737
- DOI: https://doi.org/10.17816/clinpract632973
- ID: 262737
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Abstract
BACKGROUND: Treatment of deep chronic wounds with the bone tissue involvement against the background of lower limb atherosclerosis and diabetic foot syndrome does not fit any reasonable hospital stay duration and at the same time has no effective outpatient methods. Therapy with conditioned medium derived from human mesenchymal stem cells (CM-MSC) may be a solution for this problem.
CLINICAL CASE DESCRIPTION: Patient F., 77-year-old, arrived for an outpatient treatment of local necrosis in the area of the 1st toe of the left foot in April, 2022. The main diagnosis: Peripheral arterial disease of the lower extremities. Multifocal atherosclerosis. Occlusion of the superficial femoral and popliteal arteries, diffuse lesions of the lower leg arteries on the left. Chronic arterial insufficiency of the 4th degree. Attempts of revascularisation of the left lower limb. Limited gangrene (Wagner IV) of the 1st toe of the left foot. Associated diseases: insulin-dependent type 2 diabetes mellitus (for more than 30 years). Diabetic polyneuropathy. Diabetic foot syndrome, neurotrophic form. Local treatment was performed by the microsurgical debridement of the affected surface in combination with the method of multilayered dressings, according to the previously patented technology. The microsurgical treatment of the bone surface in the wound area was carried out with the use of CM-MSC. Positive dynamics in the form of a partial closure of the bone fragment with soft tissue was observed on the sixth month of therapy. The complete closure of the open bone fragment was observed in 12 months from the beginning of the outpatient treatment.
CONCLUSION: The developed method of treatment using CM-MSC can be effective for chronic wounds with open bone surfaces.
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##article.viewOnOriginalSite##About the authors
Olga V. Pavlova
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies
Author for correspondence.
Email: vasa-vasorum@mail.ru
ORCID iD: 0000-0002-9459-7391
Russian Federation, Moscow
Vladimir A. Kalsin
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies
Email: vkalsin@mail.ru
ORCID iD: 0000-0003-2705-3578
SPIN-code: 1046-8801
Russian Federation, Moscow
Mikhail A. Konoplyannikov
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies; First Sechenov Moscow State Medical University (Sechenov University)
Email: mkonopl@mail.ru
ORCID iD: 0000-0003-1180-2343
SPIN-code: 9211-6391
PhD, Cand. Sci. (Biol.)
Russian Federation, Москва; МоскваSofia M. Kuznetsova
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies
Email: sophijka1010@yandex.ru
Russian Federation, Moscow
Victor L. Baldin
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies
Email: baldinvl@gmail.com
ORCID iD: 0000-0003-3033-5605
MD, PhD
Russian Federation, MoscowYulia S. Sukhanova
Russian National Research Medical University named after N.I. Pirogov
Email: sukhanova.js@gmail.com
ORCID iD: 0000-0002-1867-6813
SPIN-code: 1054-4905
Russian Federation, Moscow
Alexander V. Smirnov
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies
Email: alvsmirnov@mail.ru
ORCID iD: 0000-0003-3897-8306
SPIN-code: 5619-1151
MD, PhD
Russian Federation, MoscowVladimir P. Baklaushev
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies; Russian National Research Medical University named after N.I. Pirogov; Federal Center of Brain Research and Neurotechnologies; Pulmonology Scientific Research Institute
Email: baklaushev.vp@fnkc-fmba.ru
ORCID iD: 0000-0003-1039-4245
SPIN-code: 3968-2971
MD, PhD
Russian Federation, Moscow; Moscow; Moscow; MoscowYuri V. Ivanov
Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies
Email: ivanovkb83@yandex.ru
ORCID iD: 0000-0001-6209-4194
SPIN-code: 3240-4335
MD, PhD, Professor
Russian Federation, MoscowReferences
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